Surgeons have used various methods for repairing hernias, or closing openings in order to prevent the onset of complications for their patients. A hernia is a hole or a defect in the fascia and muscular layers of the abdominal wall. An incisional hernia occurs at the site of a previous surgical incision. As a means of background, the following information is known to be used by surgeons to assist their patients. However, the currently known information does not solve the problems solved by the current invention.
In a current method of repair, the hernia sac is dissected and opened and any organs contained in the sac are freed and replaced back into the abdomen. The size of the defect is measured and a piece of mesh is prepared so that it is large enough to overlap the edges of the hernia defect by 3–5 cm on all sides. In the present art, fixation of the mesh is performed by placement of sutures using a “suture-passer” device. Grasping and feeding of the suture in to the grasping arm of the “suturepasser,” within the abdomen, is technically difficult and cumbersome because the laparoscopic camera provides a mono-planar view rather than a three-dimensional (3D) view only. Fixation or suturing of the mesh to the abdominal wall is technically difficult, especially in laparoscopic surgery. Additionally, fixation of mesh to the abdominal wall is also time consuming.
With regard to repairing a laparoscopic opening, in the current art, it is necessary to insert a suture through the musculo-fascial layer on each side of the laparoscopic opening. The small skin incision restricts visibility for the surgeon so that it is usually not possible to place a safe and a secure suture. Consequently, the alternative techniques involve passage of a suture, using a hollow needle, into the abdominal cavity through one side of the musculo-fascial layer at the edge of the laparoscopic opening. The suture is released and the needle is reinserted into the abdominal cavity through the musculo-fascial layer on the other side of the laparoscopic opening. The suture is fed into the grasping arm of the needle which is then withdrawn to the outside. Two ends of the suture are then tied together so that the musculo-fascial opening is closed.
U.S. Pat. No. Re. 34,021, by Mueller et al., discloses percutaneous fixation of hollow organs. More specifically, the patent discloses a percutaneous fixation device and methods for the fixation of a hollow organ of a living body to a body wall. The method of the invention for the percutaneous fixation of organs is characterized by the steps of inserting a hollow needle carrying a retaining device attached to a filament through the skin into the organ, releasing the retaining device from the needle, and fixing the organ by adjusting the tension on the filament and clamping the filament by means bearing on the exterior of the body, as described in column 3, lines 10–17. The patent discloses the use of this method specifically for the anchoring of hollow organs without the need for a complex operation. Organs such as the stomach, kidney, gallbladder, large and small bowel, urinary bladder and duodenum are specifically mentioned in column 7, lines 31–34.
U.S. Pat. No. 4,347,847, by Usher, discloses a method of hernia repair. More specifically, the patent discloses a method which comprises repairing hernias by suturing surgical mesh to tissues in flattened form by suturing through the border edges of the mesh to adjacent tissue and bridging the hernial defect, the surgical mesh having sufficient openings even when doubled to permit rapid tissue growth through it, as described in column 2, lines 9–14. The patent acknowledges that in repair of hernias, such as incisional and inguinal hernias and defects in the abdominal and chest walls, it is important to promote growth of the tissue through the mesh to provide additional strength to the repaired area, as discussed in column 7, lines 30–34. Accordingly, the utility of using a mesh material for repairing an incisional hernia has been disclosed.
U.S. Pat. No. 5,176,692, by Wilk et al., discloses a method and surgical instrument for repairing hernia. More specifically, the method comprises inserting a balloon and inflating it such that the hernia is sealed. Subsequently, as described in the abstract, an inert polymeric material is provided for inducing human tissue growth. The device used for inducing human tissue growth may be a device such as a mesh web made of a biologically inert and flexible polymeric material, as described in column 2, lines 34–36. The method disclosed in this patent is directed toward repair of abdominal wall hernias.
U.S. Pat. No. 5,290,217, by Campos, discloses a method and apparatus for hernia repair. More specifically, the technique disclosed is used for hernias of tissue within the human body. The patent discloses various materials that have been used in experimental or clinical hernia repairs, including, for example, polypropylene mesh, Dacron fabric, tantalum gauze and the like, as described in column 2, lines 2–4. The patent additionally discloses the use of a patch having a series of punch holes, preferably all around the periphery at an approximate spacing from the edge equal to the span of the surgical staples, and of a diameter approximating the width of one limb of the clip or staple applicator as further described in column 2, lines 66–68 and column 3, lines 1–2. The patent additionally discloses that the patch is used in endo-clip or endo-staple application for manipulating and attaching the patch over a defect, as detailed in column 4, lines 10–12.
U.S. Pat. No. 5,391,182, by Chin, discloses an apparatus and method for closing puncture wounds. More specifically, the patent provides an apparatus and method for threading the ends of a suture into the body through the facial tissue surrounding a puncture opening or wound and for looping the ends out of the body through the wound so as to create a suture loop which, upon tightening, reapposes the fascial tissue as described in detail in column 2, lines 30–36.
What is needed, then, is a method for the repair of surgical hernias and surgical openings, wherein the method removes the disadvantages and the technical difficulties associated with the art described above. Additionally, the needed method would provide the resolution to the issue of the difficulty of the removal of the T-bars, also known as anchors, from the body.